captioning sponsored by macneil/lehrer productions >> brown: an historic ruling at the supreme court today, as the justices voted 5-4 to uphold president obama's "affordable care act," including its center-piece: the individual mandate. good evening, i'm jeffrey brown. >> woodruff: and i'm judy woodruff. on the "newshour" and online tonight: in-depth coverage with marcia coyle and susan dentzer; reaction from top congressional leaders; ray suarez with stakeholders, plus the political landscape ahead. >> brown: and hari sreenivasan has the other news at the end of the program including today's contempt of congress vote against u.s. attorney general eric holder. and the latest on the colorado wildfires. that's all ahead on tonight's "newshour." major funding for the pbs newshour has been providedy:

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thank you. >> woodruff: the many months of speculation finally came to an end today. the u.s. supreme court issued a landmark decision on health care reform on the last day of its term. "newshour" health correspondent betty ann bowser begins our coverage. >> reporter: the crowd gathered outside the supreme court broke into applause when the five to four decision was announced this morning. ( applause ) the court upheld the centerpiece of the 2010 health care law: the individual mandate. it requires nearly all americans to get health insurance or pay a fine. the goal is to expand coverage to 32 million americans who don't have it now. conservative chief justice john roberts joined the court's four

liberals-- stephen breyer, ruth bader ginsburg, elena kagan and sonia sotomayor-- in the majority. >> reporter: president obama hailed the court's finding when he appeared later in the east room of the white house. >> i know there will be a lot of discussion today about the politics of all this-- about who won and who lost. that's how these things tend to be viewed here in washington. but that discussion completely misses the point. whatever the politics, today's decision was a victory for people all over this country whose lives will be more secure because of this law and the

supreme court's decision to uphold it. >> reporter: republican presidential hopeful mitt romney was also in washington for the decision. >> what the court did not do on its last day in session, i will do on my first day if elected president of the united states. and that is i will act to repeal obamacare. what the court did today was say that obamacare does not violate the constitution. what they did not do was say that obamacare is good law or that it's good policy. obamacare was bad policy yesterday. it's bad policy today. >> reporter: today's decision was the result of lawsuits brought by florida, 25 other states and the national federation of independent business and several individuals. the justices also ruled on another key provision of the law that requires states to expand the medicaid program which provides health care to the poor. the court said that exceeded the federal government's constitutional authority, but ruled states could refuse to

participate in the expansion and they could not be penalized for doing so. >> brown: marcia coyle of the "national law journal" was in the courtroom this morning and, of course, is here with us tonight. marcia, yes to the mandate but not on the grounds that had been the focus of so much,o4o attent. explain. >> that's right. five justices-- the conservative justices, this time, led by chief justice roberts-- did accept the opponent's argument that there is a line in terms of how congress can legislate under this commerce clause. the commerce clause regulars interstate commerce and chief justice roberts said that presumes that there is activity to regulate. what the individual mandate did in terms of the commerce clause was attempted to regulate inactivity. roberts said there are in m things that people do not do and if the court upheld congress's power under the commerce clause

it would open a new and vast area of regulation. >> pelley: but he accepted the that it could be done under tax power. >> under congress's power to tax and spend for the general welfare. >> brown: i wanto pull up a line from chief justice's robert's opinion. "whether the mandate can beeld under the commerce clause is a question about the scope of federal authorit"de how surprising was this that he went to argue that argument? it was argued in the... it was heard in the oral arguments but never got much attention. >> well, it was surprising only because most of the commentary for the last two years by legal scholars, by political people, by court watchers, focused on the commerce clause argument and also in the lower court it seemed to dominate. but the government had always

argued as a second basis for upholding the statute that the individual mandate was valid under congress's tax and spending power. >> brown: and there's no question here as to who the key figure is, right? it's the chief justice. >> absolutely. and on the tax and spending power the chief justice this time was joined by the four of the court's more liberal members. and there's an old rule that the court does follow that if a statute of capable of being interpreted in two ways and one way it's unconstitutional, the other it is not and the court will save the statute by looking to the constitutional way and that's why the chief justice then after disposing of the commerce clause argument took a look at the tax and spending argument. >> brown: people listening as it unfolded thought he was first getting rid of the mandate. >> absolutely. >> brown: you were surprised there listening? >> yes. it sounded very much like the statute was going to fall. >> brown: he was striking down the whole thing.

>> it sounded that way but those of us who followed it knew there was... and he even announced at the beginning that there were two issues he had to address. it was very interesting the solicitor general of the united states and almost his entire office was sitting at the table immediately in front of the court and i'm sure that they also were getting worried. >> brown: all dissent was the four conservatives who the chief justice often sides with, but they put up... they wrote a strong dissent. let's look at one little excerpt from that. >> the four dissenters, as you pointed out, are the more conservative members of the court. justice kennedy read a summary of it. it was unusual because it was a joint dissent, and that means no that no one of the four took responsibility for authorship. but they would have struck the

entire statute. they didn't find anything that could stand once they felt that the individual mandate and the medicaid portion of the statute which they said were essential to the statute achieving its reform, once they felt that was was unconstitutional everything had to fall. >> brown: you just said medicaid because this is a whole key part we'll be exploring through the program tonight. >> very important part. >> brown: explain. that part of the decision was 7-2. >> yes. the chief justice and six other justices came to the conclusion that because the statute threatened to withhold all existing medicaid funds from those states that did not agree to participate in an expanded medicaid program that that crossed the line from inducement to coercion. the court then in another... in

another association of justices saved that.... >> pelley: it was a confusing day. >> it was. what the chief did then was to say the program will not be struck down but we will remove the threat. and that threat of withholding the existing funds. by removing the threat it is now the choice of the state whether they want to participate or not. >> brown: we're going to go into that later in the program with susan dentzer. but i just want to ask you. this was so anticipated, right? what did it feel like sitting there in the courtroom today? it was electric. as soon as the buzzer went off that the court was coming through the red velvet curtain to take their seat it was pack most of the justice' spouses were sitting in the guest section. even retired justice john paul stevens showed up when the entire office of the solicitor general came in that also upped

the electricity. they were visiting senators in the audience, the press section was filled to overflowing even behind the pillars and the regular pews so, yes, it was quite electric. the justices seemed very calm and most of them seemed tired. (laughs) >> brown: well, their work is done for this term. marcia coyle of the national law journal, thanks as always. my pleasure. >> woodruff: and now we have two takes on the court's judgment from senior members of congress. first, we are joined by representative steny hoyer of maryland. he is the democratic whip in the house. i talked to him this evening. congressman steny hoyer, thank you for joining us. >> good to be with you, judy, thank you. >> pelley: what does the supreme court ruling mean for the country? >> i think it means that people can have confidence that they are, in fact, going to have access to affordable quality health care and that we will bring prices down. as c.b.o. has said over the long run, over a trillion dollars of

savings that will be affected. that people will not be precluded from getting insurance because of a pre-existing condition but seniors will be able to get prescription drugs at reduced prices that young people who are under 26 who can't find a job can stay on their parents' policy and people who get really sick won't be told they have lifetime limits and, gee wiz, your illness is too expensive and we're dropping you from our policy. that and much more will be beneficial for the american people. >> pelley:.... >> woodruff: the court did rule it's constitutional but many americans it's still unpopular. what do you say to americans who are worried about the cost going up, worried about less choice? >> well, actually, they're... choices are going to be expanded not diminished. further more, i think the costs will be contained. i think nobody can say actually that their costs are going to go down but we know that health

care costs have been going up at two three times inflation. actually, they've already slowed. we think this action by the supreme court will over the long term and c.b.o., our congressional budget office, non-partisan office, has said that as well. so we think it's going to help contain costs, make health care more affordable for people and give access to people who can't afford health insurance and they will get some help in order to have that insurance and security. >> brown:. >> woodruff: what about, though, the republican argument that many employers are going to be incentivized to drop coverage. that it's going to be cheaper for them to take their employees off the role, fay penalty, frankly leaving people in the lurch with insurance that they can't afford to buy. >> well, clearly we're going to have to make sure that doesn't happen. and we're going to have to be looking at and talking to employers between now and 2014 to ensure that the program works

as expected. that is that people will be able to keep their insurance, that employers can keep their employees as they are now and that people won't be losing their insurance. but if they do lose their insurance, if somebody becomes unemployed, laid off, they will be able to have access to a policy through the exchanges. so that they will have more security not less. >> woodruff: what about congressman huier what the court said in upholding this but only as a tax does that make it harder to sell this to the american people? >> i think the republicans have made much of that. they sustained a loss. they were positive the bill was unconstitutional. they said so onn?é,ñ the regular basis but the fact of the matter is the court upheld it, said it was constitutional. now, the tax that we're speaking of is a contribution, from my standpoint, to purchasing health insurance, taking personal responsibility for your own health insurance that others

paying their health insurance premium don't have an extra thousand dollars on their bill to pay your costs. it's very much like having to have car insurance when you drive a car to make sure that if you injure somebody through an accident that you have the ability to compensate that individual for their injury. in this case to make sure that if you get sick, if you get in an accident, if something happens to you that you need health care that you will have the ways and means to compensate for that health care and have access to affordable quality care and not have the reliance on the rest of america to pay your bill. >> woodruff: one other questions what about in terms of medicaid what the court has said about the ability of states frankly to opt out of the expanding medicaid coverage. what about those people whose income level is above poverty level who may not have a choice now of what to do.

>> i haven't read that part of the opinion. we've been very busy on the floor of the house but clearly one of our efforts was to make sure that everybody did have access to insurance, particularly those who could not afford it, the poor. so we're going to have to look at that to make sure that we don't have people who are poor who can't afford insurance don't fall through the cracks. so i can't say specifically because i haven't read that portion of the opinion. clearly we're going address that and make sure that people are protected. >> woodruff: as you know, republicans are saying they are going to continue to try to repeal this, they've called for a vote in the house in the middle of july and they say if they can't do it under this president they'll do it under a president romney. >> well, of course president romney proposed a program almost exactly like the program is that the supreme court said was constitutional. so it's a little ironic that a program that was almost exactly like the one president obama

proposed was proposed by governor romney that he would say it was... what was good for massachusetts was not good for the nation. in fact, as governor patrick said this morning, they have wide coverage now, almost everybody in massachusetts does have insurance and availability of quality affordable health care. the republicans have been very quick to say a this is unconstitutional, b, we want to repeal it but very, very slow and, in fact, have not offered an alternative to make sure people have access to affordable quality health care and i think that's going to be their challenge and it's easy to say "we don't like what you proposed" but much, much more difficult to come up with a proposal that will work. >> brown: we'll leave it there, congressman steny huier, the house minority whip. thank you very much. >> woodruff: and for the other side, we turn to texas senator john cornyn, he is a member of the senate republican leadership team. i talked to him earlier this evening.

senator cornyn thank you very much for joining us. >> glad to do it. >> woodruff: what is your view of what this ruling by the court means for the country? >> well, the supreme court has done its job which means now the ball's back in congress's court. while the court said the mandate is constitutional, as you know, it's very, very unpopular, as is this law in general so i believe it's now incumbent on congress to take up health care reform once again and i think we need to start over and to build a system that doesn't take over the health care system but one that's more responsive to consumers, doesn't interfere with the doctor/patient relationship and focuses on reducing costs. that's one thing obamacare did not do. in fact, it raised premiums for most people that already had health insurance. >> woodruff: let me ask you about that, because the court has now ruled the act is constitutional. it passed both houses of congress. the president signed it. the debate has gone on for

several years. why does congress... why do you and other republicans think it needs to be voted all over again? >> well, we can't afford it. that's one reason and the problem is that while the supreme court can say what's legal, what's constitution, it doesn't make policy. that's given to the responsibility to the elected representatives of the people in congress and the american people don't like this bill. they don't like the individual mandate and, of course, we're learning... we continue to learn that many of the promises that were made by the president and others that if you like what you have you can keep it, that premiums will be reduced per family of $2,500. we're seeing prices for premiums are going up. so i think this comprehensive health care reform has proven largely to be a failure and that's why i think we need to start again. >> woodruff: well, the president said today, as i'm sure you know he said that 250 million

americans who already have health care insurance are going to be able to keep it, he said it's just going to be more secure and more affordable. >> well, i'm sorry to say this, but the president's wrong. that's not true. indeed, most of the predictions by groups like mckenzie, the business consulting group, is that once these state-based insurance exchanges are created that all of the incentives are going to be for employers to drop their employees from their coverage. we're already beginning to see that. and that as many as 0%, maybe as high as 60% or more will find themselves dropped if their employer-provided coverage. and this is in addition to the fact, judy, that in order to finance there we've seen new taxes now as the supreme court's called this a tax on the middle-class in effect for the mandate and we've seen other taxes that have gone up and this is contributing to the slow growth and recovery of the economy because employers are telling me we don't know what the rules are, we don't know how

much this is going to cost and we simply are not hiring new people. so this is really been a real wet blanket on job creation in the country. >> woodruff: what would republicans replace it with? if you were able to repeal it what would you replace it with, how quickly, and does that depend on president obama being defeatd? >> well, no, he could work with us to do something that would be more popular, but, frankly, i'm not optimistic about that this has made sure this will be front and center for elections across the country. we need to focus on holding down the cost. one of the innovations that has done a good job with that is things like high deductible insurance and health savings accounts to so people actually understand what costs are. we've also mean? the medicare program with the prescription drug program this has been one of the few successes we've seen in a government program like medicare where we actually have

competition and transparency and providers compete based on price and the quality of service and we've seen prices 40% below what was originally projected. our friends on the other side of the aisle simply don't believe in competition and using the market to help discipline prices for consumers. we know that works and it ought to be give an chance. >> woodruff: at the same time we're seeing non-partisan research that shows health care costs in many parts of the country the dramatic rise that had been there started to slow down in some cases the costs are coming down so how does that square with the republican argue that what the president is doing will raise the cost of health care. >> well, we can point to it going up ever since the obamacare bill was made into law and many won't become obvious until it becomes law in 2014.

it will be incentivized to drop their employees from what is a fringe benefit provided by the employer into these taxpayer supported or supplemented insurance exchanges and the costs there congressional budget office indicated only 7% will do that. mckenzie and others will be much higher and i think the incentives are such that no employer will maintain their employee-provided health care coverage if they can pay the penalty and get off cheaper unless they have some legal or other obligation to their employees that prevents them from doing that. so costs are going to explode you should these state-based insurance exchanges far beyond what we've seen already. >> woodruff: finely, does this replace the economy and jobs as the most important issue in this presidential campaign? >> i think it certainly elevates health care to the top tear of issues. but what i think we'll be talking about is the impact of

this failed health care policy on job creation and on the economy generally. what an impediment it's been and why our economic growth is so slow, in part because of government overrch and big policies like this which have increased the costs and made it harder on small businesses to create jobs and hire more people. >> woodruff: senator john cornyn of texas, thank you very much for talking with us. >> thank you, judy. >> brown: beyond the political response, there were many other voices reacting to the court's ruling today. we're going to hear some of that now, beginning with the highly- charged scene just outside the supreme court. and we come back to betty ann bowser. >> hey, hey, ho, ho, obamacare has got to go! >> reporter: the chaotic scene outside the supreme court stood in stark contrast to the solemnity that was going on inside. >> we love obamacare. we love obamacare! >> reporter: a kind of impromptu street theater played out on the court steps. there were belly dancers. ♪ prayer circles. people dressed in colonial

attire. >> the constitution does not allow for mandates! >> reporter: and others sporting surgical masks. and of course, plenty of cameras. >> reporter: throughout the morning, there was a circus-like atmosphere with supporters and opponents of the law competing for the attention of the crowd. and there were hundreds of people here. at one point, they stretched all the way to the sidewalk and halfway around the corner. and then the moment everybody had waited for. reporters ran out of the court room with news of the decision. supporters of the "affordable care act" were thrilled it had been upheld. >> we're the only industrialized nation that doesn't provide health care for everybody in our country. and i think that's something that needs to change. i think we're moving toward that. >> i see people with severe chronic healthcare problems, debilitating problems that could have been prevented had they had

access to primary and preventative services and i am so thrilled that this law was upheld so now those people will get that care that they need. >> reporter: but for many who opposed the law, the decision said it came as a shock. >> i think it was a momentous blunder and historians are going to look back and regard it as such and place it along other giant mistakes the court has made in the past. president obama, before the decision came out, kept saying they shouldn't be rewriting legislation, but that's exactly what they just did. >> reporter: other opponents promised to pour their all into the campaign to repeal the law in congress. >> i will be going door to door. i will also be making phone calls. i will be donating. and i'll also you know be manning the polls also. >> reporter: so many of those will turn their attention from the courtroom to the ballot box and the november elections. >> brown: now, to the real-world impact of all this. ray suarez will talk with some key players in the healthcare field.

but we begin with an overview from susan dentzer, editor-in- chief of the journal, "health affairs" and an analyst for the "newshour." so susan, in some sense it's status quo, right? things proceed rather than stop in their tracks. >> that's right. barring a change in the administration, a change in the composition or control of congress or overcoming the broad group of stakeholders that push to pass the affordable care act in the first place, barring all of that it's status quo and we move forward. >> brown: let's talk about what that means. what will happen and when. we'll keep talking about this idea of a mandate, it's a broad idea. what specifically happens and when? >> will what will happen is in 2014 when the exchanges that are going to roll out in various states are up and running individuals who don't currently have insurance who have to purchase it on the individual market or work for small businesses will be able to buy that coverage through the exchanges. if they do not do that at that

point and they elect to go without coverage they will be subject to the penalty. the penalty starts small in 2014 you won't pay it until the following year when your taxes are due, starts small, $95 for an adult, a maximum of 1% of total family income, whichever is greater. it phases up in 2016 to $695 maximum for an adult, 2.5% of total income for a family is the maximum it can be and that's where it stops and stays there, at least until someone changes the law again. >> brown: (laughs) now some areas of coverage, such as preexisting conditions, have already kicked in for some people, right? but for everybody, when does that happen >> a good way to think about it is let's talk about the 257 million americans who already have coverage. a lot of things are already in effect that apply to them. no more lifetime limits on insurance policies. so it will never be the case that you're so sick and spend so much money that your insurance

cuts out. that's's gone. for example, adult children, the one everybody knows as adult children now can stay on their parents' policy up to 26. >> brown: that's already started. >> that's already started for everybody. pre-existing condition restriction cans not be held against children. that has already gone into effect for everybody. so there are a number of those provisions already in effect for everyone. most of the insurance reforms, however, will not take effect until 2014 and, again, they apply largely to the relatively smaller group of americans who were buying individual coverage and to some degree to people who are getting coverage through the small business market. that is when for individuals buying coverage through the exchanges in 2014 no more pre-existing condition restrictions against them, there is guaranteed issue of insurance at that point and anybody who wants to get an insurance policy will be able to get one. in addition, depending on your

income level, you'll be able to do that with the assistance of federal subsidies. >> brown: now, crucially, the medicaid expansion. we started talking about that with marcia earlier. we heard lawmakers before. what's most important from your perspective in thinking about how... what happens next? >> well, the most important thing is number one that the expansion moves forward and is constitutional. but number two what the court clearly said is if states elected for some reason not to expand coverage and not to take what is really a lot of federal money up front to do that, keep in mind the federal government pays 100% of the cost of this for several years and then it drops down to 90% of the cost eventually. so federal government is paying most of the share. if states nonetheless elect not to take that money, not to expand coverage to these people, they can do that and the federal government cannot come back and take away all of the medicaid money that those states now get from the federal government.

so what in effect the court has done it appears is given states the option to turn down the expansion, turn down the dollars and not suffer any other consequences by way of losing federal support for the rest of their medicaid program. >> brown: in thinking about what they may or may not do or which states may or may not act, 26 states had sued the original act. remind us of their rationale in opposeing the medicaid extension. >> well, they had two rationales they were worried about this coerceive effect, if i say i don't want to do this i lose my medicaid money. that's coercion. they also said it was coerceive for the federal government to be paying so much of the cost. it was almost as if it was too good to be true, they couldn't possibly turn it down and that was coerceive. they lost on that argument. they've obviously won on the argument that if they decide not to go forward they won't lose their federal medicaid dollars. now we have to ask ourselves what we think is likely to

happen. but as you say, 26 states felt strongly enough about this that they filed suit and we'll see what they decide to do as a policy matter. >> brown: if they don't accept are there implications outside of their own states? i mean, implications for the wider implementation of the act as a whole? >> no question about it because half of the coverage expansion was to be carried out through medicaid so if a large number of states elect not to do that it means that many of these people-- and there are millions of them, we're talking about somewhere between 10 and 20 million people who are in this group of people who have not historically had access to... to health insurance to medicaid but would. if they are disenfranchised, in fact, that means that for example lots of hospitals that were counting on the fact that people would be insured through medicaid suddenly will have patients who are not insured that way. it really does diminish the potential to cover as many

people as the affordable care act was intended to. do. >> brown: all right, susan dentzer, thanks so much. >> great to be with you. >> woodruff: and now ray suarez gets some reaction and assessment from those who will deal with the law or had worked to overturn it. >> suarez: for that we turn to ron pollack, founding executive director of families u.s.a.-- a national organization that advocates for affordable health care in the country. karen ignagni, president of america's health insurance plans, a lobbying group that works on behalf of the health insurance industry. dr. donald palmisano, who is both a physician and an attorney. he is founder of intrepid and bill mccollum, a former congressman who, when he was florida's attorney general, sued the obama administration over the health care law. guests, i'd like to start with a quick distilled thumbnail description of your reaction to this big ruling and complex set of opinions. ron pollack? >> i think this is a hallelujah

impeachment for america's families. it l provide them with peace of mind that they will have health coverage and care when they need it and the various ways that susan and others describe, it will make sure that people no longer are denied health care coverage that they so desperately need. >> suarez: dr. palmisano? >> my reaction was one of sadness. it's not going to increase access, it's not going to enhance quality and it will increase the costs of medical care. >> suarez: karen ignagni? >> there was significant uncertainty about the market reforms and universal coverage. the court clarified that today, that the link has been established so we will not repeat the mistakes that were done at the state level. at the same time, we have to zero in now on the affordability issues which are underlying here that i suspect we'll talk about. >> suarez: finally, bill mccollum? >> i was shocked and disappointed in chief justice roberts' decision to call this a

tax instead of a penalty under the law and i think the end result of this is going to be a very negative thing for all of us. going forward there are a couple positive things out of it. number one there is big precedent here now to say that the interstate commerce clause does not... is not something that can be applied in the future to require you to buy a product or service. that's clear a majority of the court, including the chief justice, said that. i think also there's precedent being set that in the future we'll have something to go on when it comes to coercing the states in the medicaid decision. beyond the health care front. but the health care law itself is complicated. the result i think was sad and i think chief justice roberts' argument on the tax is contrived disingenuous, i think those who said he's rewriting instead of interpreting are correct but he stretched it and that's how he came out. >> suarez: karen ignagni are we done? can your members who are insurers start working under the new rule book knowing where things are going to be now?

next year? the year after? >> well, they're already working. we've been working for a year and a half in terms of taking on the implementation that's required under the legislation. >> suarez: but do you have certainty now? >> we have certainty about universal coverage, people being in the pool. the whole objective here to make sure that this can be economic, can be sustained and can be an insurance system rather than sickness fund is to have the younger and healthier people in which is why, ray, we have to now... now that we have that certainty about how the coverage provision will work, we have to turn our attention to provisions in the legislation that have not been focused on which will inadvertently increase costs and nobody wants that. so to make this possible for people to actually purchase insurance it's going to be important to focus on that. but there's time to do that between now and january 1, 2014. we're going to spend a lot of time working with people on both sides of the aisle to array

those issues and offer solutions. >> suarez: bill mccollum are we done or are the forces gathering to continue fighting this battle? >> well, i've often said no matter how the outcome of this lawsuit the debate over health care reform was just beginning with the decision and i think that's true there will be a big debate this fall and the presidential race will have a high profile part of it focused on this without a republican majority in the house and senate and new president there won't be any significant changes in this law. secondly, i think in the next couple years as the 2014 date comes and goes there are going to be more warts that show up. the financing of all of this is very complicated and i don't think it's going to work and i think congress is going to find that the individual mandate, the medicaid provisions, all the financing system in here simply won't work and they're going to have to go back and readdress portions of this. so that's how i see it going forward. plus there will be other court challenges on other parts of this law that the states don't bring but probably businesses

do. >>vfg heart of the affordable care act are the president's two main stated goals: insuring the uninsured and pushing down the rapid rise in health care costs. now that we know, we have the outlines of the system, what it is, are either of those ambitions going to be achieved? >> i don't think they will be achieved. for instance, putting more people on medicaid-- medicaid's a failed system. we ought to put congress on medicaid for two weeks and medicaid would get fixed. what we need to do... the people on medicaid need to be on something like the federal employees health benefits program where they have an array of choices and they can pick and choose the company that they want. we should allow more health savings accounts. we should fix the broken medical liability system. we should allow people a-to-buy across state lines so no health insurer gets too much power, too much concentrated power. those are the things that will work. the broken liability system, 92%

of the cases that go to trial, the physician wins and 82% of the cases are closed with no payment when you look at all the cases and the statistics repeat themselves, the contingency fee is a big push for that. so those add billions of dollars in extra tests because physicians are afraid. >> suarez: ron pollack, same question. if the affordable care act really wanted to do two things-- cover the uninsured, lower cost increases-- is it going to do that? >> well, first, with respect to coverage, this is going to expand coverage for tens of millions of people. today we have 50 million people in the country who are uninsured. that's one out of six people in the population. that's more than the aggregate population of half the states in the country, the least populous states in the country. this is going to expand coverage for tens of millions of people. it does so in two ways: one, it provides subsidies for

middle-class and moderate-income people and families so that they can better afford health care coverage and even though the medicaid provision was changed somewhat, there are there is going to be a huge expansion in medicaid as well and i disagree with my friend don. i think the medicaid program is highly satisfactory for the people on the program. it provides terrific service. so i think the coverage aspect of this is going to happen and will work. now with respect to cost we have a lot of work to do but one thing that is important, the extra costs because so many people are uninsured because these costs get passed on to people who have insurance averaged a few years ago at more than 1,000 per family coverage. when you cover these additional people who are used to being

uninsured that ling l bring the pressure down in terms of premiums. >> suarez: karen, did the of this law depend on each other to make all the numbers work? and once you take that medicaid piece of it out of there and the state mandates out of there do the numbers still add up? >> well, i think there are two separate questions: one is the medicaid piece. we're obviously going to have to think about the safety net to the extent states don't go forward with medicaid expansion, what happens to individuals who would be in that category who would fall between the cracks. so think that's going to have to be a conversation about that, number one. in terms of how congress constructed the legislation, round about the summer of 2009 the health insurance discussion shrunk from health reform to health insurance reform and i think that in an underlying way has created an issue with

respect to cost containment that we need to zero in on. i'm going to give you an example. there's a provision in the legislation because revenue is necessary that taxes individuals purchasing coverage. smauz businesses that purchase coverage. in the end that's going to be for a small business person a 3% additional hit. nobody wants that. that's moving in the wrong direction. there are other provisions in the legislation-- unintentional, but move in the i don't know direction. so i think now that this this clarity with respect to what happens with respect to constitutionality of the mandate it's time to go back to the underlying provisions and say will they contain costs? do we have unintended consequences? what will they be and how do we address it? there's 18 months and i think that's what people need to do to roll up their sleeves and talk about that. across the isle on both sides. >> suarez: you were one of the early leaders against the fight of the affordable care act, bill mccollum. now that the court has ruled on

the constitutionality of the new medicaid rules do you see that opposition continuing? will the 25 other states along with your home, florida, opt out now that the court has given them the option of doing that? >> i think a good number will opt out. i think the choice they have to make based on the lack of flexibility there's not just a money question of whether the federal government picks up on them on the payments to those eligible but also the question of all of the contrived things that are in there that you have to comply with you don't under current medicaid. so i'll add one thing i think is very important to this. the whole idea behind this affordable air contact of the federal government expanding this greatly from top down is going to be a big problem in the future for accessibility. we already have a doctor shortage in the country. we have a situation where cost cutting is going to be the name of the game that will be the name of it driven by the federal

government under these laws greater than ever before and as doctors spend less time per patient, less time in... trying to diagnose conditions people are going to get poorer quality care. we have the greatest quality care in america of any place in the world at any time in history. i worry and i think the american people should be that with already existing looming big doctors doctor shortage and this added incentive to cut costs and time being spent with patients you're going to see big problems in this country with this law and eventually it will get changed for that reason. >> suarez: quick as possible response? >> you know, with respect to florida, florida right now, for example, in its medicaid program it only covers parents with family incomes... three-person family of less than $10,000. four-person family less than $12,000. single adults, childless couples they get nothing today even if they are literally penniless. because the federal government is providing 100% of the funding in the next three years and it

will never go below 90% to help expand coverage through the medicaid program i think even states like florida will opt into this because it's hard to reject this from the federal government. >> suarez: quick final comment. >> let me chime in on this program... >> it's price fixed and they pay the physicians less than the cost of delivering care. so talk to medicaid patients and see how easy it is to find a specialist. the majority can't find a specialist in the hour of need. price fixing has never worked in the history of the world. you lose the service or the product. >> suarez: i'm sorry, bill mccollum? >> i'm concerned about what's going to happen to the existing medicaid program itself. that's where the hidden costs are because if more people become enticed to have to join medicaid because of the fact that the individual mandate is the in place and they have to have insurance the states have to pickm( there are a lot of people today who are not currently covered who are currently eligible. the federal government doesn't pick up 100% of those costs in

the future under this law. so there are a lot of hidden things that states are going to consider when they look at this and it will be a very difficult thing. not as simple as a couple guests have said. >> suarez: we'll have to end it there. guests, thank you all >> woodruff: the ruling reverberated on the campaign trail today. how will it play out this election year? "newshour's" political editor christina bellantoni is here to discuss that. so christina, there was an immediate effect on the trail. >> absolutely. mitt romney came out and spoke but one thing the campaign is telling us is he was able to raise $2.5 million from 24,000 people in less than eight hours after this decision came out. they feel as if they've galvanized something. they feel as though they're able to capture this momentum perhaps to get people to get to the polls in november because he's promising "i'll repeal it." of course you're seeing congress making an effort on this, too. they're going they have to vote on july 11.

we've already voted on this in the house. many times the republican have said they wanted to repeal it. >> woodruff: so a clear coordination between the republicans in congress and the romney camp. you've also been talking to the obama camp in chicago. there s there a chance they'll take a moment to sell health care reform in the country? >> you heard what the president said when he talked about stories of health care reform saying it's not about the politics but the people behind it. that was the message communicated to the campaign volunteers. they had an all staff meeting in chicago. people described it as emotional and people really wanted to start telling the stories of people helped by health care reform. you'll see a lot of that on television, certainly on the internet, youtube videos, that thing. and michelle obama is the first campaign... first person on the campaign trail. she did an event in memphis and she said "get the details of health care reform. help people understand what's in

it. she went through line by line and talked about the things in it. that will be the new type of message communication here for them. >> woodruff: just quickly, a sense that conservatives energized by this? >> you're seeing it not just from republicans but people on the ground, organizations are saying we'll vow to elect mitt romney so we can get rid of this and romney's trying to hone in and capitalize on that energy. >> woodruff: so both sides girding again to do battle. >> brown: and in case you couldn't follow the day's developments as they unfolded, we did that online. there you can catch up on the speeches, the analysis, and reactions to the decision. you weighed in with questions on twitter and in a live chat. plus, we annotated the ruling to highlight key passages from both the majority and minority opinions. all that is on our website. and there were other major stories on this day. hari sreenivasan has those. >> sreenivasan: in the day's other major washington story, the confrontation between house republicans and the u.s. attorney general eric holder came to a head in a pair of contempt-of-congress votes.

"newshour" congressional correspondent kwame holman has our report. >> the resolution is agreed to. >> reporter: with that, attorney general holder became the first cabinet member to be held in criminal contempt by the u.s. house of representatives. in a separate vote, lawmakers also held the attorney general in civil contempt. it stemmed from his refusal to turn over additional documents related to "operation fast and furious." the botched gun-smuggling investigation that contributed to the death of a u.s. border agent. holder argued the 7,600 pages of material the justice department already turned over should be enough. republicans, however such as south carolina's trey gowdy, demanded more, since some details of what they were initially told, turned out to be inaccurate. >> for those who want a plea bargain, my question to you is this: will you settle for 75% of truth? is 50% of the truth enough for you?

is a third? or do you want it all? because if you want all the truth then you want all the documents. >> reporter: but new york's carolyn maloney and other house democrats, charged republicans are merely on a political witch hunt. >> this is not about discovering the truth. this is about politics. this has become an obsessive political vendetta pursuing a political agenda in a season of unusually ugly politics. >> reporter: in the end, more than half of the democrats walked out in protest, refusing to vote on the measures. the criminal contempt resolution approved today sends the matter to the u.s. attorney for the district of columbia who, under the law actually, reports to holder. the civil contempt finding allows the house to take holder to court to get what it wants. shortly after the votes, the attorney general spoke in new orleans and voiced regret that it's come to this. >> today's vote may make for good political theater in the

minds of some, but it is at base both a crass effort and a grave disservice to the american people. they expect and they deserve far more. >> reporter: but the house is unlikely to see more documents soon, because president obama invoked executive privilege last week to justify withholding them. on wall street today, stocks spent much of the day in doldrums, after the supreme court's health care ruling. but a late rally erased much of the losses. in the end, the dow jones industrials shed less than 25 points to close at 12,602. the nasdaq fell nearly 26 points to close at 2,849. shares of j.p. morgan-chase fell another 2.5% on word that its trading losses could be far worse than expected. the "new york times" reported the red ink could reach $9 billion, more than four times the bank's original estimate. the losses stem from a bungled strategy to hedge against financial risk. officials in colorado today reported enormous destruction from a wildfire blazing outside

colorado springs. it's one of more than 40 major blazes burning, some of the rgest in colorado, and many of them near population centers. the mountain town of colorado springs was blanketed again with thick smoke, obscuring the devastation. but the mayor announced the waldo canyon fire had burned hundreds of homes to the ground, since it doubled in size on tuesday. >> we are working through the process which is very painstaking assessing every address making sure we have absolutely accurate information on each address. the worst thing we could do is put out information that's inaccurate. the people who are impacted by this are already going through enough pain and anguish. we've got to make sure we get this right. >> sreenivasan: this aerial photo showed one neighborhood before the fire and after, total destruction. >> you could feel the heat. it was just really intense and then we had cops yelling at us to get out get out. they're running around the neighborhood. it was insane.

>> sreenivasan: the blaze still burned out of control today, and fire officials warned it was too dangerous for investigators to get in, just yet. >> i'm a veteran of the denver fire department for 20 years and to me it was like a movie scene. the whole side of the mountain is on fire. that's the only way i can describe it to you. >> sreenivasan: but fire managers were more optimistic about making progress aided by slightly better weather. >> we've been standing out here in the wind and it's been hammering us. just standing here at this news briefing it's been doing also, up in the forest. but today we're not going to have that. the weather looks like it' s cooperating with us and we >> sreenivasan: for now, many people are living in shelters-- at school gyms, hotel banquet rooms or tents in open fields. all told, more than 32,000 people have been forced to flee. >> we barely got anything. we just got a few backpacks with some clothes and all of our important papers and that was it. >> reporter: to the north, near fort collins, more evacuees from

the massive high park fire were allowed to return home today, as firefighters contained more of that blaze. in iraq today, a wave of bombings and shootings across the country killed 22 people and wounded more than 50. the deadliest strike came in western bahgdad. eyewitnesses said a taxi exploded outside a market in a shi-ite neighborhood. eight people died in that blast. more than 200 iraqis have died in attacks during june, making this the deadliest month there since january. a u.s. law passed at the height of the war in iraq has been thrown out. the supreme court today rejected a statute that made it a crime to lie about receiving top military medals. in a 6-3 decision, the court found it violated the right to free speech. the "stolen valor" act went into effect in 2006. it imposed fines and up to one- year prison sentences. rupert murdoch's media conglomerate news corp will divide into two companies. the announcement today said one new company will operate as a newspaper and book publisher. the other will focus on entertainment. the plan is subject to final approval by the news corp. board and regulatory agencies.

those are some of the day's major stories. we have more coverage of today's health care decision online plus these stories. i talked to science correspondent miles o'brien. he's working on a piece about alan alda's flame challenge, a competition that tests scientists' communication skills. the judges of the contest: 6,000 11-year-olds. you'll find that on our rundown blog. margaret warner has a new dispatch from mexico about the presidential frontrunner's plan to combat the country's violent cartels. that's on our world page. all that and more is on our website: newshour.pbs.org. jeff? >> brown: and that's the "newshour" for tonight. i'm jeffrey brown. >> woodruff: and i'm judy woodruff. we'll see you online and again here tomorrow evening with mark shields and michael gerson among others. thank you and good night. major funding for the pbs newshour has been provided by:

and the william and flora hewlett foundation, working to solve social and environmental problems at home and around the world. and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. captioning sponsored by macneil/lehrer productions captioned by media access group at wgbh access.wgbh.org